Building Blocks For Dental Practice Success

Do you have symbiotic or life sucking relationships in your dental practice?

Sept. 26, 2014
What kind of relationships you develop as the leader of your practice make all the difference in your success.

I am quite sure many dentists believe their relationship with their staff members is symbiotic in nature. But, what kind of symbiotic relationship is it? Is it of a facultative symbiotic nature, which means that the doctor chooses to live and work with his or her employees but does not have to, or is it a mutualistic symbiotic relationship, where the two absolutely depend on one another to survive?

That’s a tough one. Early in my days as a boss, I believed I had a facultative arrangement. I liked to think I called the shots and others helped me achieve my goals – um, I mean our goals But, really, it was about my goals. I just assumed that’s how it worked. I thought I didn’t need my team members to survive; they were replaceable. I did not have to have a certain person to be successful in my day-to-day routines. After all, in dental school I could complete a procedure all by myself, with a rubber dam in place and the patient holding the suction. I could do it all if I had to. Despite my rationale, private practice is a whole different beast. No patients really want to hold the suction, or have you reach over them to change an instrument. Yet, we hold on to that thought that we can do it all if we need to. We can, but is that the best way to treat patients or other team members? I don’t think so.

The trend in dentistry is clearly to move from an employee model to a more partnership model, both with staff members – as illustrated by many using the term “team” members instead of “staff” members, and in patient care, as dentists work to create partnerships with their patients instead of top-down authoritarian relationships. The best and brightest employees want this kind of relationship, and so do most patients.

How, then, do we go from facultative to mutualistic in our symbiotic thinking? It starts with recognizing a problem. Maybe everyone in your office loves the facultative way of doing things. Maybe you never have staff turnover, never lose patients, make gobs of money, and feel great at the end of each day. If you have this type of facultative relationship, it can work as long as everyone agrees on the relationship. Keep it that way. It’s good to be King or Queen. But at some point, I would guess the monarchy will collapse.

As time passes, I believe new employees will want something more mutualistic. Patients will also want more input in their treatment due to their ability to gather data on the Internet. They will want a more mutualistic relationship with their doctors. To evolve to this type of relationship with our team members and patients, we must evaluate everything from the language we use, to the messages we send with our body language. Moreover, we have to want to change.

I had to learn the hard way. I had to lose a couple of key employees to realize my facultative ways were not working. Fortunately, I’m a fairly quick learner. Even more fortunate was my access to a plethora of leadership books on my husband’s bookshelves. Once I figured out plan A was not working, I was glad to find plan B nearby. I listened to practice management consultants, read their books, and listened to their DVDs. That was then. Now, webinars, books, DVDs, podcasts, articles, social media groups, and seminars are readily available. If only time was also readily available. Learning to take the time to read and learn about relationships, communication, or business concepts seems hard when clinical techniques and products are always changing; the pressure to keep up clinically is hard enough. There has to be a balance, however, between clinical and practice management education. The ship will sink if either area is left unattended for too long.

There is one more type of relationship that deserves discussion – the parasitic relationship. These relationships cause us to hate work. If we treat our team members like unimportant parts of a machine, they feel underappreciated and may lose interest in their work. When employees are asked what is most important to them, they consistently say appreciation ahead of wages. This is a sign of a mutualistic team player. We cannot suck the life out of our employees, nor can our employees suck the life out of us.

If we flex and bend too much in our efforts to lead, employees can take over and steer the ship in the wrong direction. This often leads us to feel disrespected, out of control, deflated, and lifeless. There has to be a balance, guided by a desire to have a mutualistic symbiotic relationship. Neither doctor nor team should dominate. There will be decisions doctors have to make independently, but whenever possible, group input should be provided, so that everyone’s opinions are recognized. It’s not just about one person’s desire, as I once thought. Team members want to help patients improve their health as much as the doctors do.

Patient health and care is the purpose team members and doctors should rally around to avoid unhealthy work relationships. When we lose sight of that common goal, it’s easy to start becoming a vampire dentist, or to fall victim to a vampire team member. By keeping a symbiotic mutualistic relationship, we appreciate others’ roles and realize that without one another, neither would survive for very long.

It’s my goal to help others develop more relationships like the clown fish and sea anemone rather than the parasitic tick and worm. Learning how to develop meaningful relationships is not as straightforward as gross anatomy or biochemistry. It takes time and effort. We think we know how to develop relationships, or that we can manage on our own. We are interconnected and complex, and therefore we must learn to work together with our patients and with our team members … symbiotically … with mutualism, or we risk having the life sucked out of us, or sucking the life out of others. Creating a professional work environment takes time and a willingness to stick to a common goal.

I believe that like many things in nature, when we find those complimentary relationships with others, we survive much longer.

Dr. Lisa Knowles founded IntentionalDental Consulting to help guide others to a more purposeful life. In her 15 years as a dentist, she has lived dentistry, loved dentistry, and loathed dentistry. Her contribution to the profession is an ability to look at the whole picture – from foundational communication needs to clinical provider shortcomings. Dr. Knowles practices in Jackson, Michigan, and helps teach a communication course at the University of Detroit Mercy Dental School. Contact Dr. Knowles at [email protected], and follow her blog at